Minimally invasive retroperitoneal approach for lumbar corpectomy and anterior reconstruction

2000 ◽  
Vol 93 (1) ◽  
pp. 161-167 ◽  
Author(s):  
Manfred Mühlbauer ◽  
Wolfgang Pfisterer ◽  
Richard Eyb ◽  
Engelbert Knosp
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Spinal Fusion ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Content Type ◽  
Anterior Reconstruction ◽  
Fine Print ◽  
Lumbar Corpectomy

✓ The anterior decompressive procedure in which spinal fusion is performed is considered an effective treatment for thoracolumbar fractures and tumors. However, it is also known to be associated with considerable surgery-related trauma. The purpose of this study was to show that lumbar corpectomy and anterior reconstruction can be performed via a minimally invasive retroperitoneal approach (MIRA) and therefore the surgical approach—related trauma can be reduced. The authors studied retrospectively the hospital records and radiological studies obtained in five patients (mean age 67.4 years, range 59–76 years) who underwent lumbar corpectomy and spinal fusion via an MIRA followed by posterior fixation. Four patients presented with osteoporotic compression fractures at L-2 and L-3, and one patient presented with metastatic disease in L-4 from prostate cancer. Neurological deficits due to cauda equina compression were demonstrated in all patients. The MIRA provided excellent exposure to facilitate complete decompression and anterior reconstruction in all patients, as verified on follow-up radiographic studies. All patients improved clinically. A 1-year follow-up record is available for four patients and a 6-month follow-up record for the fifth patient; continuing clinical improvement has been observed in all. Radiography demonstrated anatomically correct reconstruction in all patients, as well as a solid fusion or a stable compound union in the four patients for whom 1-year follow-up records were available. The MIRA allows the surgeon to perform anterior lumbar spine surgery via a less invasive approach. The efficacy and safety of this technique and its potential to reduce perioperative morbidity compared with conventional retroperitoneal lumbar spine surgery should be further investigated in a larger series.

Minimally invasive retroperitoneal approach for lumbar corpectomy and reconstruction

1999 ◽  
Vol 7 (6) ◽  
pp. E6 ◽  
Author(s):  
Manfred Mühlbauer ◽  
Wolfgang Pfisterer ◽  
Richard Eyb ◽  
Engelbert Knosp
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Spinal Fusion ◽  
Spine Surgery ◽  
Surgical Approach ◽  
Retroperitoneal Approach ◽  
Lumbar Spine Surgery ◽  
Spinal Reconstruction ◽  
Lumbar Corpectomy

Anterior decompressive surgery with spinal fusion is considered an effective treatment for thoracolumbar fractures and tumors. However, it is also known to be associated with considerable surgical approach–related trauma. The purpose of this study was to show that lumbar corpectomy and spinal reconstruction can be performed via a minimally invasive retroperitoneal (MIR) approach and therefore, the surgical approach–related trauma can be reduced. The hospital records and radiological studies obtained in five patients (mean age 67.4 years, range 59-76 years) who underwent lumbar corpectomy and spinal fusion via an MIR approach were studied retrospectively. Four patients presented with osteoporotic compression fractures at L-2 and L-3 and one patient with metastatic disease at L-4 from prostate cancer. In all patients neurological deficits due to cauda equina compression were demonstrated. The MIR approach provided excellent exposure to facilitate complete spinal decompression and reconstruction in all patients, as verified on follow-up x-ray studies. All patients improved clinically. A 1-year follow-up record, available for four patients, showed evidence of continuing clinical improvement and, radiographically, a solid fusion or a stable compound union and anatomically correct reconstruction. The MIR approach allows anterior lumbar spine surgery to be performed less invasively. The efficacy and safety of this technique compared with the conventional retroperitoneal approach to lumbar spine surgery should be further investigated in a larger series.

Ischemic optic neuropathy following lumbar spine surgery

1995 ◽  
Vol 83 (2) ◽  
pp. 348-349 ◽  
Author(s):  
Andrew G. LEE
Keyword(s):  
Blood Pressure ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Optic Neuropathy ◽  
Visual Loss ◽  
Lumbar Spine Surgery ◽  
Ischemic Optic Neuropathy ◽  
Content Type ◽  
The Right ◽  
Fine Print

✓ This 48-year-old hypertensive man, a cigarette smoker, awoke in the recovery room with visual loss in the right eye after uncomplicated lumbar spine surgery. His intraoperative blood pressure had been maintained at relatively low levels to reduce bleeding; a loss of 1500 cc of blood was reported. Postoperative hemoglobin was 4.2 g/dl less than the preoperative hemoglobin; however, the patient did not receive a blood transfusion. A postoperative ophthalmological examination revealed decreased visual acuity, color vision, and visual field in the right eye. The right optic nerve and retina were initially normal but the patient eventually developed optic nerve atrophy consistent with the clinical diagnosis of ischemic optic neuropathy. Neurosurgeons should be aware that this condition may follow uncomplicated lumbar spine surgery and should obtain prompt ophthalmological consultation when patients develop postoperative visual loss. Aggressive and rapid correction of blood pressure and hematocrit may be helpful in individuals who develop ischemic optic neuropathy after lumbar spine surgery.

Chondroblastoma of the lumbar spine

2005 ◽  
Vol 2 (5) ◽  
pp. 596-600 ◽  
Author(s):  
Raphaël Vialle ◽  
Antoine Feydy ◽  
Ludovic Rillardon ◽  
Carla Tohme-Noun ◽  
Philippe Anract ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Local Recurrence ◽  
Osteolytic Lesion ◽  
Radicular Pain ◽  
Appendicular Skeleton ◽  
Lumbar Region ◽  
Content Type ◽  
Anterior Posterior ◽  
Fine Print

✓ Chondroblastoma is a benign cartilaginous neoplasm that generally affects the appendicular skeleton. Twenty-six cases of spinal chondroblastoma have been reported in the past 50 years, only six of which were located in the lumbar region. The authors report two cases involving this exceptional location. In both patients, low-back pain, in the absence of radicular pain, was the presenting symptom. In both cases, plain radiography and computerized tomography scanning revealed an osteolytic lesion surrounded by marginal sclerosis. Magnetic resonance imaging allowed the authors to study the tumor's local extension. Examination of a percutaneous fluoroscopy-guided biopsy sample revealed the following typical histological features of chondroblastoma: chondroid tissue, focally alternating with cellular areas, and no nuclear atypia or pleomorphism. To reduce the risk of local recurrence, vertebrectomy and anterior—posterior fusion were performed in both cases. In one case, a structural lumbar scoliosis was corrected during the posterior procedure. There was no postoperative complication. No recurrence was observed during the 3- to 6-year follow-up period. The surgery-related results were deemed successful. Although exceptional, the diagnosis of chondroblastoma is possible in lesions involving the lumbar spine. Other spinal locations are described in the literature, and frequency of recurrence is stressed. A vertebrectomy is advised to reduce the risk of local recurrence.

77. The incidence of subsequent lumbar spine surgery after lumbar disc arthroplasty: a minimum two-year follow-up

2020 ◽  
Vol 20 (9) ◽  
pp. S37-S38
Author(s):  
Dean C. Perfetti ◽  
Austen Katz ◽  
Alan Job ◽  
Jesse M. Galina ◽  
Alexander M. Satin ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Lumbar Disc ◽  
Lumbar Spine Surgery ◽  
Disc Arthroplasty ◽  
Lumbar Disc Arthroplasty
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